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Credit Insurance Class Action Against Resource Life to Proceed

A credit insurance class action lawsuit against Resource Life will proceed, a Georgia court has ruled. If you have been treated unfairly by an insurance company, contact Lexington, Kentucky insurance lawyer Robert Abell at 859-254-7076.

Health Insurers Reimbursement Rates Target of Class Action

What are the usual, customary and reasonable rates for which health insurance company will reimburse for services provided by an out of network doctor or hospital? A class action lawsuit filed in Florida claims that health insurance companies artificially and wrongfully deflate these reimbursement rates, thus costing consumers and families millions of dollars annually.

Cancellation of Insurance Leads to $37 Million Verdict

Cancellation of medical insurance by Assurant Health following a car wreck that inflicted substantial injuries and bills has led to a $37 million verdict returned by a Boulder, Colorado jury.

Insurer Systematically Underpaid Claims, Lawsuit Says

Underpayment of claims and strong-arming policyholders was an insurance company's systematic business practice, a lawsuit claims.  The insureds claim that the Texas Windstorm Insurance Association used below-market rates to reach low-ball estimates for material and repair costs, unfairly limited costs on roof repairs by coercing homeowners to accept used materials and by refusing to re-open closed claims.

Source:  Houston Chronicle

Lexington, Kentucky insurance lawyer Robert Abell represents claimants, families and insureds in lawsuits and claims against insurance companies. 

Insurance Companies' License To Kill: ERISA

ERISA, the federal law that applies to almost all health insurance that is obtained through employment, is a license to kill for insurance companies says Doug Drenkow on OpEd.com., "The Insurance Companies' 'License To Kill': ERISA."  Drenkow quotes in proof from an opinion from the United States Court of Appeals for the Third Circuit on the shortcoming and perverse incentives created by ERISA:

"[A]t the same time as ERISA makes it inordinately difficult to bring an injunction to enforce a participant's rights, it creates strong incentives for HMOs to deny claims in bad faith or otherwise 'stiff' participants. ERISA preempts the state tort of bad-faith claim denial ... so that if an HMO wrongly denies a participant's claim even in bad faith, the greatest cost it could face is being compelled to cover the procedure, the very cost it would have faced had it acted in good faith. Any rational HMO will recognize that if it acts in good faith, it will pay for far more procedures than if it acts otherwise, and punitive damages, which might otherwise guard against such profiteering, are no obstacle at all. Not only is there an incentive for an HMO to deny any particular claim, but to the extent that this practice becomes widespread, it creates a 'race to the bottom' in which, all else being equal, the most profitable HMOs will be those that deny claims most frequently."

Health Care Reform: How To Right The Wrong of Coverage Denied

What can be done where insurance coverage for necessary medical treatment is denied?  For those covered by a policy obtained through their employment the answer is almost surely not very much.  For the vast majority of individuals and families whose health insurance comes through employment, their policies are covered by the federal law known as ERISA.  Where insurance coverage is wrongfully denied under a policy subject to ERISA, the only thing that can be done is to sue the insurance company for the cost of the denied treatment.  Meanwhile, of course, the person who needed the treatment may die without it.

The Los Angeles Times, "Righting Wrongful Denials of Insurance Coverage," suggests that two elements could be included in health care reform that would help in these situations: (1) more consumer choices among insurance companies; and, (2) better guidelines about necessary and appropriate treatments.

Suit Against CIGNA For Taunting Family of Dead Cancer Patient May Go Forward

After CIGNA refused to pay for a liver transplant for her cancer-stricken 17 year old daughter and her daugher died, Hilda Sarkisyan traveled to the insurance company's Philadelphia headquarters for an apology.  Instead of an apology Mrs. Sarkisyan was heckled and taunted by CIGNA employees.

Although the federal ERISA law barred any suit against CIGNA to make it responsible for the death of her daughter, a suit against CIGNA for the emotional distress caused by the insurance company's egregious misconduct taunting of Mrs. Sarkisyan may go forward a court has ruled the Los Angeles Times reports, "Couple Battle To Make Insurers Liable For Coverage Decisions."

The Los Angeles Times provides a link to a speech given by Wendell Potter, a former CIGNA spokesman, to the Civil Justice Foundation. Mr. Potter acknowledges that "HMOs and insurers are largely free to deny access to care without fear of reprisal or financial consequences."

Lexington, Kentucky insurance claims lawyer Robert Abell represents individuals and families against insurance companies in insurance claims and ERISA cases. 

$10 Million Verdict Against Fortis for Cancellation of Health Insurance Upheld

The cancellation of an insured's health insurance on false pretenses resulted in a $10 million verdict against Fortis Insurance Company. The Supreme Court of South Carolina upheld the verdict in a recent decision.

Fortis, which is now known as Assurant Health, cancelled the health insurance of Jerome Mitchell Jr. solely because a nurse wrote down the wrong date of an HIV diagnosis test.  Later, the insurance company was twice presented with evidence showing the correct date of the test but it refused to reinstate Mitchell's health insurance for over two years, during which time Mitchell was unable to get proper medical treatment. 

The South Carolina Supreme Court labeled the insurance company's conduct "highly reprehensible" and upheld a jury verdict awarding $1.1 million in damages to cover the medical treatment that Mitchell should have received and a $10 million punitive damage award.

Lexington, Kentucky insurance lawyer Robert L. Abell represents individuals and families with regard to insurance claims cases.

HMOs Deny 1 In 5 Claims, Study Shows - Insurance Claims Lawyer

HMOs deny 1 in 5 claims for medical care a study done by the California Nurses Association has found.  The study was based on data collected from 2002 to June 30, 2009, by the California state government.  The five largest HMOs in California denied 31.2 million insurance claims. 

$14.6 Million Verdict On Uninsured Motorist Claim -- Lexington Accident Lawyer

A paralyzed truck driver received a $14.6 million verdict on an uninsured motorist lawsuit.  The truck driver swerved to avoid a car that ran a stop sign and his truck overturned.  He was paralyzed in the accident.  His insurer, National Casualty Company, denied coverage forcing the injured truck driver to sue.

Homeowners Insurance Class Action Against Nationwide Settled - Kentucky Insurance Lawyer

A class action lawsuit claiming that Nationwide Insurance underpaid homeowners on their homeowners insurance clailms has been settled reports the Columbus Dispatch, "Nationwide Settles Suit Alleging It Underpaid."  The lawsuit covered homeowners who filed claims between January 1, 1996 to March 2009 and claimed that Nationwide did not pay enough to cover claims because it withheld money that would have covered contractors' overhead and profit.  Under the settlement Nationwide will pay claimants an amount equal to 20% of the amount that it has already paid. 

$6.2 Million Verdict In Disability Insurance Bad Faith Case

A disability insurance company's bad faith practices have yielded a $6.2 million verdict to a claimant's estate reports the Rapid City Journal, "Federal Jury Awards Local Woman's Estate $6.2 Million." 

The claimant, a high school Spanish teacher, took a home equity loan and, as a measure of protection, purchased disability insurance.  Her health began to fail, she had to stop working full-time and she was eventually diagnosed with cancer.  When she filed a claim, the insurance company made up a bogus ground that she had filed her claim too late.  She hired a lawyer, who caught them in their lie and they then paid up in part.  The jury awarded $200,000 in compensatory and $6 million in punitive damages.  There was evidence that the insurance company systematically used deceptive practices to deny legitimate claims.  The case is Powell v. CUNA Mutual Insurance Society.

Uninsured Motorist (UM) Benefits Payable Where Employee Killed by Co-Worker's Negligence

The estate of an employee killed by a co-worker's negligent operation of their employer's vehicle may recover uninsured motorist (UM) benefits from their own policy the Kentucky Court of Appeals recently ruled in State Farm v. Slusher, No. 2008-CA-000169-MR (February 27, 2009). The Court rejected State Farm's argument that payment of UM benefits was barred because workers compensation benefits had been paid to the Estate.